Are people really losing faith in the NHS?

New research from The King’s Fund and Nuffield Trust shows that public satisfaction with the NHS has dropped to a 25-year low. This, for many people living in the UK, might come as somewhat of a surprise.

NHS staff worked tirelessly in the most trying conditions during the height of the Covid-19 crisis and were widely lauded for their bravery in confronting what were unprecedented conditions. Images of doctors and nurses dressed in bin bags with abrasion-stained faces circulated on social media to ubiquitous applause. All the while, people were making incredible sacrifices in an attempt to “protect the NHS”. However, with Covid-19 seemingly absent from the government’s list of priorities, the NHS’ underlying deficiencies and the Covid backlog have coincided to produce conditions so desperate that public sympathy is wearing thin.

The truth is, this moment has been coming and, somewhat ironically, the pandemic only delayed what was clearly inevitable. In 2019, public satisfaction with the NHS had fallen to its lowest level for a decade. At the time, Niall Dickson, chief executive of the NHS Confederation, said: “These findings show the inevitable consequence of starving the NHS of funding for the best part of a decade. We should be under no illusions about the scale of the task we face to restore public confidence in the health service.” Having since been confronted by the crippling Covid-19 crisis, and with waiting lists only heading in one direction, Dickson’s words ring as true – indeed if not louder – in 2022 as they did three years previously.

Chronic staff shortages are top of the agenda. Jeremy Hunt – who chairs the Commons health and social care select committee – explained that the NHS was short of 93,000 workers and that “unless we have future proof workforce planning, it will not be possible to address the NHS backlog and the cycle of crises putting dangerous pressure on staff will continue.” Furthermore, in a recent NHS Staff Survey from NHS England and NHS Improvement, “just 27% of people working in the NHS… [believed there to be] enough staff in their organisation to allow them to do their jobs properly…” The issue, therefore, is just as acute, and frustrating for staff, as it is for patients.

The situation for patients and staff is likely to get worse before it gets better, with some estimating that waiting lists could extend to around 10 million in 2024 before numbers begin to fall. For now, some patients are being asked to travel over 200 miles in a bid to tackle daunting elective care waiting lists.

Likely to further exacerbate the situation is the fact that last week saw the new Social Care Levy come into effect. But an increase in tax will surely only raise expectations in a health service that, in reality, is barely coping. In time, this will create a new focus for public discontent, “we’ve paid for it, where is it?” will become an increasing issue which will no doubt become a major focus of political campaigning from now until the General Election.

For health communicators, the task is complex. The problems for the NHS are so stark and seemingly persistent that patients are crying out for measures that will meaningfully address the crisis. The public are seemingly tired of the pandemic being used to justify the lack of progress. With a lack of a concrete plan, so far, to point to, the task for health communicators looks set to remain difficult. Survey results also point to people having more confidence in their local service, but fear a bleaker national picture. Local health communicators will all have good work to promote from their organisations, and local engagement with their communities will be essential to both involve them in how their services evolve and help them understand the daunting pressures they face.

While the public perception of the NHS, and indeed the service it provides, is evidently in decline, the key tenets that form the basis of what the NHS represents remain overwhelmingly popular. Over 80% of respondents in 2021 answered favourably to the statements: that the NHS should be free at the point of use, that it should be funded primarily through taxes and that the care should be accessible to everyone.

Consequently, while the NHS is undoubtedly facing enormous challenges, the public has not lost faith in the NHS and its founding principles. There is, however, a clear frustration with the quality of the service it currently provides. Equally clear is that the NHS is in desperate need of direct political intervention. The Social Care Levy must only represent the first step in this process; there is still so much more that needs to be done. Consecutive governments have relied on the public’s goodwill attached to the NHS as an excuse for inaction for far too long. That goodwill is eroding rapidly and restoration looks a daunting task.

Importantly, for every horror headline, there are hundreds of outstanding achievements, for every frustration there are thousands of everyday positive patient experiences, and while millions are on the waiting list, hundreds of millions are seen and cared for every year. The NHS story is never simple and its communications professionals have a key role to play in helping their organisations, staff and communities to shape it.